Midland Lutheran Admissions

Housing Application

Thank you for your interest in living on campus at MLC! Please complete the form below. Following the submission of this form, you will receive an email confirming that Midland Lutheran College has received this form. If you do not receive a confirmation email please call the Office of Admissions at 800-642-8382 ext. 6501.

All first year students are assigned roommates. You may indicate a preferred roommate below or we will use our roommate matching system to identify one for you.

Processing of housing assignments for incoming students does not start until June 1. Please do not re-submit your housing application. Housing assignments will be mailed by July 1.

Personal Information

First Name:

Middle Name:

Last Name:

Maiden Name:

Preferred First Name:

Mailing Address:

City:

County:

State:

Zip Code:

Home Phone:

Cell Phone:

Email:

Nonresident alien:
A person who is not a citizen or national of the United States and who is in this country on a visa or temporary basis and does not have the right to remain indefinitely.

Are you a Non-Resident Alien?

Additional Information

Student ID #:

Gender:

Intended area of study:

Student Status:

Enrollment status:

Term to Begin Enrollment:

Year to Begin Housing:

Housing Information

The 2009-2010 rate for a traditional, double room with a roommate is $1,210/semester. The Department of Residence Life attempts to honor requests as space and preferences are available. Preferences cannot be guaranteed.

First choice:

Second Choice:

Meal Plan Options

All students living on campus are required to have a meal plan. Please select the plan that best suits your needs.

Choice of meal plan:

Roommate Request

If you would like to request a specific individual as your roommate, please enter the name below. Roommates must be of the same sex. Roommate requests must be mutual.

First name:

Last name:

Roommate Preferences

Comfort in living style is critical to students' well-being and academic success. Midland Lutheran College makes every attempt to assign roommates with similar styles so please be honest in your response to the following questions. Please note: You must complete this section even if you have a roommate in mind.

Do you smoke?

Will you accept a roommate that smokes?

(Although the residence halls are smoke free, having a roommate who smokes may affect your living environment.)

I have more energy:

Are you a day or night person?

When do you usually go to bed?

How do you describe your room?

If you plan to participate in intercollegiate athletics please specify the sport(s) here.

Sport:

We value the diversity of our students and believe that interaction with people of diverse backgrounds enhances the learning experience. Having a roommate with a different cultural or ethnic background is a unique opportunity to learn about others and yourself.

Would you value this opportunity?

Confirmation

Please enter your initials below to certify that you are the person who has completed this form.

Initial here: